Jerzy Pobocha
Abstract
Different definitions of delusions and their history are critically examined. The analyzed definitions includeDSM-III, DSM-IVR, ICD-10 and those found in textbooks of clinical/forensic psychiatry and in dictionaries. Examples of mistaken diagnoses in forensic psychiatric evaluations such as, for example,latent schizophrenia, paranoid hypochondria, and schizophrenia, such as incorrectly diagnosed in A.B. Breivik of Norway, are discussed. It is shown that mental processes, such as making judgments, are influenced by other mental factors such as anxietyand personality disorders, physical health, educationalbackground, intellectual capacity, cultural background, political and religious views. It is thus concluded that delusions are false judgments which cannot be corrected or explained in a different way, that is, as beliefs, attitudes, prejudices, overvalued ideas, compulsive thoughts, phobias, simulation, etc. Incorrect diagnoses of delusion made by psychiatricexperts result from their limited knowledge, insufficientclinical experience, not taking into considerationthe impact of the aforementioned factors on thinking and behaviour of evaluated individuals, utilizing abbreviated, incomplete definition of delusion,and a tendency to over-diagnose.There are many different points of view on the natureof delusions and many different definitions of what a delusion is. Mayer-Gross believes that “it is impossible to define a delusion without being involvedin philosophical controversies unessential from a pragmatic point of view”[31]. The definition offeredby Gruhle is that “a delusion is seeing relationshipbetween things without any reason. Delusion is a mood without a reason”[18]. Kretschmer thought that delusion prevented one from getting a clear insightinto things “which are neither logical nor systematicbut only alive” (die weder logisch noch systematischsondern nur lebendig sind) [26].
Keyword(s): delusion, delusion-like idea, overvalued idea, fanaticism, over-diagnosis, forensic evaluation
DOI: 10.5200/sm-hs.2014.016
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